Older adults with advanced kidney disease sometimes want to stop dialysis but often meet resistance from doctors, new research shows. We explore options available to these patients, including conservative care.

Diabetics dying because they can’t afford insulin. Organ transplant patients undergoing “wallet biopsies” to get on waiting lists. Are out-of-pocket costs going to dominate the health discussion in the next election? Margot Sanger-Katz of The New York Times, Joanne Kenen of Politico and Rebecca Adams of CQ Roll Call join KHN’s Julie Rovner to discuss this as well as new Trump administration rules giving states the ability to make major changes to the Affordable Care Act. Also, lame-duck lawmakers in Wisconsin and Michigan try to cement health changes before Democrats take over.

Shereese Hickson’s doctor wanted her to try the infusion drug Ocrevus for her multiple sclerosis. Even though Hickson is trained as a medical billing coder, she was shocked to see two doses of the drug priced at $123,019, with her share set at $3,620.

The dialysis industry raised nearly $111 million in a successful bid to defeat the measure, which also was opposed by hospitals and doctors. The union that sponsored the measure collected about one-sixth that amount.

Both sides in the contentious and expensive battle over California’s Proposition 8 are cherry-picking the facts ahead of Tuesday’s vote as dialysis companies spend record amounts to persuade voters through ads.

Dialysis companies have contributed more than $110 million to defeat an initiative on California’s Nov. 6 ballot that would limit their profits — breaking the $109 million record set by the pharmaceutical industry in 2016.

Consumers favor ACA’s safeguards on the promise that patients who have health problems can get insurance. In the heat of the midterm campaigns, politicians in both parties agree, but their arguments don’t always add up.

The measure, which will appear on the November ballot, seeks to cap industry profits. The SEIU-UHW union has raised almost $17 million, but opponents from the industry have invested more than four times that.